Project Summary This R15 application seeks to determine better ways of identifying child traumatic injury victims at risk for post-traumatic stress pathology (PTS) and poor functioning/quality of life (QOL) following a traumatic event. Posttraumatic stress disorder (PTSD) researchers have identified a number of risk factors for the development of PTSD; however, together these risk factors account for a relatively small percentage of the variance in subsequent PTSD symptoms. The present study tackles this issue from two directions. First, although threat sensitivity (TS) and inhibitory control (IC) have been found to independently predict PTS, growing evidence supports a model whereby risk associated with high TS may be mitigated by high IC. In contrast, high TS paired with lower levels of IC control may be a uniquely strong predictor/correlate of psychopathology onset, functional limitations, and decreased QOL. Thus, we will examine the extent to which the interaction of these two key interdependent trans-diagnostic mechanisms (TS * IC) predicts persistent post-traumatic negative sequelae. Further, the present proposal also argues that a focus on a single diagnostic outcome (PTSD) may be another reason for our poor identification of at-risk child trauma victims. Instead of attempting to improve the prediction of a single disorder with extremely heterogeneous symptom presentation, the present proposal focuses on the extent to which the interaction TS * IC predicts child PTS (PTSD, depression, anxiety) and functioning (quality of life, functional impairment). An additional variable that must be taken into account in child trauma studies is the influence of family factors on a child's recovery. Prospective examination of the dynamic relationship between a child victim's responses to a traumatic injury and family factors within the home environment (specifically parental TS/IC, parent-child conflict, and positive parenting behaviors) will allow for examination of the development of child symptoms over time as well as the determination of mechanisms through which parent and child post-event symptoms interact to impact child functioning/QOL. We will recruit 400 child traumatic injury patients and their parents/guardians (efforts to target male parents/guardians are detailed). Participants will be recruited in-hospital, and follow-up assessments will occur 1-, 3-, and 6-months later. By focusing on a dimensional perspective to understanding risk for PTS, poor functional outcomes, and decreased QOL in child traumatic injury victims, the present study aims to explore a model designed to improve the early identification of individuals likely to suffer from post-traumatic sequelae who would benefit from targeted intervention approaches, as well as to inform the appropriate matching of therapeutic approaches.